| NPI | 1639838675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11020199) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 30843) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2022-11-22 |